| NPI | 1932572658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REZA KESHAVARZI Owner 786-801-3883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2019-07-19 |